Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel

Tripathy, Swagata; Vijayaraghavan, Bharath Kt; Panigrahi, Manoj Kumar; Shetty, Asha P; Mishra, Rajesh; Beane, Abi

doi:10.5005/jp-journals-10071-23782

Cited by 5 publications

(1 citation statement)

References 33 publications

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“…In a recent survey of healthcare worker perceptions on the impact of the pandemic led by our group 20 , respondents reported a decline in acute care service utilisation and a delay in time-sensitive procedures such as percutaneous coronary angioplasties. In the view of the respondents, fear of contracting infection and lockdown were seen as having contributed the most to such disruptions.…”

Section: Discussionmentioning

confidence: 98%

Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India

Adhikari¹,

Beane²,

Devaprasad³

et al. 2021

Wellcome Open Res

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Background: Coronavirus disease 2019 (COVID-19) has been responsible for over 3.4 million deaths globally and over 25 million cases in India. As part of the response, India imposed a nation-wide lockdown and prioritized COVID-19 care in hospitals and intensive care units (ICUs). Leveraging data from the Indian Registry of IntenSive care, we sought to understand the impact of the COVID-19 pandemic on critical care service utilization, case-mix, and clinical outcomes in non-COVID ICUs. Methods: We included all consecutive patients admitted between 1 st October 2019 and 27 th September 2020. Data were extracted from the registry database and included patients admitted to the non-COVID or general ICUs at each of the sites. Outcomes included measures of resource-availability, utilisation, case-mix, acuity, and demand for ICU beds. We used a Mann-Whitney test to compare the pre-pandemic period (October 2019 - February 2020) to the pandemic period (March-September 2020). In addition, we also compared the period of intense lockdown (March-May 31 st 2020) with the pre-pandemic period. Results: There were 3424 patient encounters in the pre-pandemic period and 3524 encounters in the pandemic period. Comparing these periods, weekly admissions declined (median [Q1 Q3] 160 [145,168] to 113 [98.5,134]; p<0.001); unit turnover declined (median [Q1 Q3] 12.1 [11.32,13] to 8.58 [7.24,10], p<0.001), and APACHE II score increased (median [Q1 Q3] 19 [19,20] to 21 [20,22] ; p<0.001). Unadjusted ICU mortality increased (9.3% to 11.7%, p=0.015) and the length of ICU stay was similar (median [Q1 Q3] 2.11 [2, 2] vs. 2.24 [2, 3] days; p=0.151). Conclusion: Our registry-based analysis of the impact of COVID-19 on non-COVID critical care demonstrates significant disruptions to healthcare utilization during the pandemic and an increase in the severity of illness.

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Section: Discussionmentioning

confidence: 98%

Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India

Adhikari¹,

Beane²,

Devaprasad³

et al. 2021

Wellcome Open Res

Self Cite

View full text Add to dashboard Cite

show abstract

Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Coronavirus disease 2019 (COVID-19) has been responsible for over 3.4 million deaths globally and over 25 million cases in India. As part of the response, India imposed a nation-wide lockdown and prioritized COVID-19 care in hospitals and intensive care units (ICUs). Leveraging data from the Indian Registry of IntenSive care, we sought to understand the impact of the COVID-19 pandemic on critical care service utilization, case-mix, and clinical outcomes in non-COVID ICUs. Methods: We included all consecutive patients admitted between 1st October 2019 and 27th September 2020. Data were extracted from the registry database and included patients admitted to the non-COVID or general ICUs at each of the sites. Outcomes included measures of resource-availability, utilisation, case-mix, acuity, and demand for ICU beds. We used a Mann-Whitney test to compare the pre-pandemic period (October 2019 - February 2020) to the pandemic period (March-September 2020). In addition, we also compared the period of intense lockdown (March-May 31st 2020) with the pre-pandemic period. Results: There were 3424 patient encounters in the pre-pandemic period and 3524 encounters in the pandemic period. Comparing these periods, weekly admissions declined (median [Q1 Q3] 160 [145,168] to 113 [98.5,134]; p=0.00002); unit turnover declined (median [Q1 Q3] 12.1 [11.32,13] to 8.58 [7.24,10], p<0.00001), and APACHE II score increased (median [Q1 Q3] 19 [19,20] to 21 [20,22] ; p<0.00001). Unadjusted ICU mortality increased (9.3% to 11.7%, p=0.01519) and the length of ICU stay was similar (median [Q1 Q3] 2.11 [2, 2] vs. 2.24 [2, 3] days; p=0.15096). Conclusion: Our registry-based analysis of the impact of COVID-19 on non-COVID critical care demonstrates significant disruptions to healthcare utilization during the pandemic and an increase in the severity of illness.

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Gastrointestinal bleeding during the COVID-19 pandemic: More severe and less clear

Kerbage

Barada

Alrazim

et al. 2022

Preprint

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Background The COVID-19 pandemic has led patients to avoid medical care, and hospitals to limit high-risk procedures. Methods We conducted a cohort study to assess the impact of the COVID-19 pandemic on the presentation and outcomes of gastrointestinal bleeding (GIB). Results Patients admitted during the pandemic were more likely to present with severe hemorrhage and to have a drop of hemoglobin ≥ 2g/dL. The origin of GIB was also more likely to remain unknown. Admission during the pandemic was an independent predictor of severe hemorrhage (HR = 2.08, [1.07–4.05]). Conclusion During the COVID-19 pandemic, patients with GIB were more likely to present with more severe hemorrhage.

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Collateral Impact of the COVID-19 Pandemic on Acute Care of Non-COVID Patients: An Internet-based Survey of Critical Care and Emergency Personnel

Cited by 5 publications

References 33 publications

Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India

Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India

Impact of COVID-19 on non-COVID intensive care unit service utilization, case mix and outcomes: A registry-based analysis from India

Gastrointestinal bleeding during the COVID-19 pandemic: More severe and less clear

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